go back

Wisconsin rates for HCPCS 99251

Inpatient consultation for a new or established patient, which requires these 3 key components: A problem focused history; A problem focused examination; and Straightforward medical decision making. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are self limited or minor. Typically, 20 minutes are spent at the bedside and on the patient's hospital floor or unit.

Facilitymedian $54 · 10th–90th $35–$2000%20%40%10th90th$54Professionalmedian $151 · 10th–90th $40–$5010%20%10th90th$151$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $151.36
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $199.53 / $199.53
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $501.19 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $50.12 / $53.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $43.65 / $85.11